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Wang DB, Jiang JB, Zhang HJ, Wu D, Zhang YH, Cui LB, Zhang J, Wang XH. Mental health problems of front-line medical staff in the early stage of public health emergencies. Front Psychiatry 2024; 15:1377815. [PMID: 38736629 PMCID: PMC11082394 DOI: 10.3389/fpsyt.2024.1377815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
In the face of the unprecedented public health crisis caused by the novel coronavirus pneumonia epidemic, front-line health workers are under enormous mental pressure. This paper aims to explore the mental health challenges faced by front-line health workers in the early stages of a public health emergency, such as stress, anxiety, and depression. At the same time, the factors that increase their mental stress are analyzed, and practical measures are put forward to prevent and manage mental health problems, aiming at improving the quality of medical treatment during public health emergencies. This paper has some reference value for people engaged in mental health prevention.
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Affiliation(s)
- Dong-Bao Wang
- Department of Psychiatry, Xijing 986 Hospital, Fourth Military Medical University, Xi’an, China
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Jin-Bo Jiang
- Department of Psychiatry, 93307 Military Hospital, Shenyang, China
| | - Hai-Jun Zhang
- Department of Psychiatry, Xijing 986 Hospital, Fourth Military Medical University, Xi’an, China
| | - Di Wu
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Ya-Hong Zhang
- Department of Psychiatry, Xi’an Gaoxin Hospital, Xi’an, China
| | - Long-Biao Cui
- Department of Psychiatry, Xijing 986 Hospital, Fourth Military Medical University, Xi’an, China
- Shaanxi Provincial Key Laboratory of Clinic Genetics, Fourth Military Medical University, Xi’an, China
| | - Jian Zhang
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- Department of Respiratory Medicine, Xi’an People’s Hospital (Xi’an No. 4 Hospital), Xi’an, China
| | - Xiao-Hui Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Martins P, Luzia RWS, Filho JAP, Welsh KS, Fuzikawa C, Nicolato R, Alemão MM, Gonçalves MA, Cavalheiro JC, Ávila ID, Veiga RT. Prevalence and factors associated with burnout among health professionals of a public hospital network during the COVID-19 pandemic. PLoS One 2024; 19:e0298187. [PMID: 38648225 PMCID: PMC11034648 DOI: 10.1371/journal.pone.0298187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/20/2024] [Indexed: 04/25/2024] Open
Abstract
Burnout is most commonly defined as a syndrome characterized by emotional exhaustion, cynicism, and ineffectiveness, which occurs in response to chronic stressors at work. It can adversely affect health workers' physical and mental health, and the quality of care provided. The COVID-19 pandemic increased stressors and could impact burnout prevalence in this group. There is a lack of information regarding the prevalence of burnout among hospital health workers in Brazil. A newer definition of burnout has been proposed that considers three different clinical profiles: the frenetic, underchallenged and worn-out subtypes. This differentiation could lead to interventions tailored for each subtype. The present study aimed to estimate the prevalence of burnout, its subtypes, and associated factors in workers of a public hospital network in Brazil, during the pandemic. A total of 143 randomly selected participants answered an online form that included sociodemographic and occupational items, and the Burnout Clinical Subtypes Questionnaire, a summarized version. This questionnaire evaluates three burnout dimensions (overload, lack of development, neglect) that can be used to discriminate the three burnout subtypes (frenetic, underchallenged, worn-out, respectively); higher scores indicate higher burnout levels. The prevalence of burnout was high (53.85%), similar to other studies during the pandemic. The most common subtypes were 'frenetic' (34.97%), characterized by increased efforts to meet work demands, to the point of neglecting personal needs, and 'lack of development' (23.78%), characterized by a sense that work is uninteresting and does not contribute to personal development, and a perfunctory behavior towards tasks. Age was associated with burnout: workers with less than 51 years presented higher levels of burnout. These findings indicate the need for effective interventions to prevent and/or treat burnout. The assessment of burnout subtypes can allow managers to better understand the processes affecting employees, and inform actions to improve workforce health.
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Affiliation(s)
- Patricia Martins
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Richardson Warley Siqueira Luzia
- Statistics and Workforce Management Center at Hospital Foundation of the State of Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazil
| | - Jair Alves Pereira Filho
- Statistics and Workforce Management Center at Hospital Foundation of the State of Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazil
| | - Kelly Silva Welsh
- Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
| | - Cíntia Fuzikawa
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Nicolato
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Márcia Mascarenhas Alemão
- Department of Health Management, School of Nursing, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Márcio Augusto Gonçalves
- Department of Administrative Sciences, Faculty of Economic Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - José Carlos Cavalheiro
- Department of Letters, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ianny Dumont Ávila
- Academic at the Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Teixeira Veiga
- Department of Administrative Sciences, Faculty of Economic Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Akhavan AR, Zhan T, Lall MD, Barton MA, Reisdorff EJ, Hu Y, Bilimoria KY, Lu DW. Suicidal ideation, perception of personal safety, and career regret among emergency medicine residents during the COVID-19 pandemic. AEM EDUCATION AND TRAINING 2024; 8:e10955. [PMID: 38516253 PMCID: PMC10951625 DOI: 10.1002/aet2.10955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 03/23/2024]
Abstract
Objectives The COVID-19 pandemic was disruptive for trainees and may have affected career decisions for some learners. This study examined the impact of the pandemic on emergency medicine (EM) resident perceptions of their mental health, perceptions of personal safety, and career choice regret. Methods This was a cross-sectional survey study administered following the 2021 American Board of Emergency Medicine In-Training Examination (ITE). Survey measures included suicidal ideation (SI), COVID concerns in terms of infection prevention and control (IPC) training, COVID risk to self and/or COVID risk to family, and COVID-related career regret. COVID concerns were compared by gender and race/ethnicity using Pearson's chi-square tests. Multivariable logistic regression models were used to test the association between SI and COVID concerns, resident characteristics, and program characteristics. Results A total of 6980 out of 8491 EM residents (82.2%) from 244 programs completed the survey. Only 1.1% of participants reported insufficient training in COVID IPC practices. Participants were concerned about COVID risk to themselves (40.3%) and to their families (63.3%) due to their job roles. These concerns were more common among women or nonbinary (vs. men); all other races/ethnicities (vs. non-Hispanic Whites); senior residents (vs. PGY-1, PGY-2 residents); and residents who were married or in relationships (vs. single or divorced). A total of 6.1% of participants reported that COVID made them reconsider choosing EM as their career. Career regret in this cohort was higher than that in the proportion (3.2%) expressing career regret in the 2020 ITE (p < 0.001). Career regret was more common among women or nonbinary (vs. men); all other races/ethnicities (vs. non-Hispanic Whites); and senior residents (vs. PGY-1, PGY-2 residents). The overall SI rate was 2.6%, which did not differ from that of the 2020 sample of EM residents (2.5%, p = 0.88). Conclusions Many EM residents reported concerns about COVID risks to themselves and their families. Although the rate of SI remained unchanged, more EM residents reported career regret during the COVID pandemic.
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Affiliation(s)
- Arvin R. Akhavan
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Tiannan Zhan
- Department of SurgeryNorthwestern UniversityChicagoIllinoisUSA
| | - Michelle D. Lall
- Department of Emergency MedicineEmory UniversityAtlantaGeorgiaUSA
| | | | | | - Yue‐Yung Hu
- Department of SurgeryNorthwestern UniversityChicagoIllinoisUSA
| | - Karl Y. Bilimoria
- Department of SurgeryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Dave W. Lu
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
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Ishii S, Jung H, Akishita M, Kawamura A. Prevalence and associated factors of work impairment among geriatricians during the COVID-19 pandemic in Japan. Geriatr Gerontol Int 2024; 24 Suppl 1:215-220. [PMID: 38131637 DOI: 10.1111/ggi.14772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/30/2023] [Accepted: 11/19/2023] [Indexed: 12/23/2023]
Abstract
AIM This study investigated work impairment and its associated factors among geriatricians during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This cross-sectional study was carried out using an anonymous online survey questionnaire administered to members of the Japanese Geriatric Society between October and December 2022. The questionnaire included questions regarding psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale) and work impairment (Work Functioning Impairment Scale). Multivariate logistic regression analyses were carried out to determine the factors associated with work impairment. Causal mediation analyses were performed to delineate the relationship between work impairment, psychological distress and fear of COVID-19. RESULTS The analytic sample included 386 geriatricians, and work impairment was observed in 24.8% of them. Work impairment was associated with age, prefecture where the institution was located and fear of COVID-19. Mediation analysis showed that the effect of fear of COVID-19 on work impairment was almost completely mediated by psychological distress. CONCLUSION During the COVID-19 pandemic, work impairment was commonly observed among geriatricians. We found that fear of COVID-19 might cause work impairment; however, this effect was exerted entirely through psychological distress. This implies that interventions to prevent or reduce work impairment among doctors should mainly target psychological distress; however, the fear of COVID-19, if it causes psychological distress, should also be addressed. Managers of hospitals and long-term care facilities must take steps to protect healthcare workers' mental well-being and maintain work productivity. Therefore, understanding the factors related to work impairment might help them devise effective measures. Geriatr Gerontol Int 2024; 24: 215-220.
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Affiliation(s)
- Shinya Ishii
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Japan
| | - Hungu Jung
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsuko Kawamura
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Japan
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Wang B, Bai Y, Wu S, Lin W, Guo J. Association between occupational burnout and psychological symptoms among Chinese medical staff: moderating role of social support. PSYCHOL HEALTH MED 2024:1-16. [PMID: 38166576 DOI: 10.1080/13548506.2023.2299666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 12/18/2023] [Indexed: 01/04/2024]
Abstract
This study aimed to examine the association between occupational burnout and psychological symptoms among Chinese medical staff, assuming social support to play a moderating role in the aforementioned relationship. The survey was conducted online from May 1 to June 28, 2022, and the questionnaires were distributed and retrieved through a web-based platform. The final sample was comprised of 1461 Chinese medical staff in this cross-sectional study. Several multiple linear regressions were performed to analyze the data. After controlling for potential confounding factors, all three dimensions of occupational burnout were associated with poorer psychological symptoms. Emotional exhaustion (β = 0.33; 95% confidence interval [CI], 1.018, 1.479) had the strongest association with psychological symptoms, followed by depersonalization and diminished personal accomplishment. Moreover, medical staff with higher levels of friend support (β = -0.11; 95% CI, -4.063, -0.573) and significant other support (β = -0.10; 95% CI, -3.965, -0.168) were less likely to suffer from psychological symptoms when faced with occupational burnout. The results suggested that interventions aimed at lessening occupational burnout and boosting social support can be an effective way to promote the psychological health of medical staff.
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Affiliation(s)
- Bingqian Wang
- Department of Health Policy and Manage, School of Public Health, Peking University, Beijing, China
| | - Yashuang Bai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing, China
| | - Songmei Wu
- Nursing Department, Luoyang Orthopedic Hospital of Henan Province, Zhengzhou, China
| | - Wei Lin
- Department of Neurosurgery, Joint Logistics Support Unit No. 904 Hospital, School of Medicine, Anhui Medical University, Wuxi, China
| | - Jing Guo
- Department of Health Policy and Manage, School of Public Health, Peking University, Beijing, China
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Akil H, Nestler EJ. The neurobiology of stress: Vulnerability, resilience, and major depression. Proc Natl Acad Sci U S A 2023; 120:e2312662120. [PMID: 38011574 DOI: 10.1073/pnas.2312662120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 11/29/2023] Open
Affiliation(s)
- Huda Akil
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
| | - Eric J Nestler
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029
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Neil-Sztramko SE, Belita E, Hopkins S, Sherifali D, Anderson L, Apatu E, Kapiriri L, Tarride JE, Bellefleur O, Kaasalainen S, Marr S, Dobbins M. What are effective strategies to respond to the psychological impacts of working on the frontlines of a public health emergency? Front Public Health 2023; 11:1282296. [PMID: 38131026 PMCID: PMC10733471 DOI: 10.3389/fpubh.2023.1282296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Background The COVID-19 pandemic has disrupted the healthcare and public health sectors. The impact of working on the frontlines as a healthcare or public health professional has been well documented. Healthcare organizations must support the psychological and mental health of those responding to future public health emergencies. Objective This systematic review aims to identify effective interventions to support healthcare workers' mental health and wellbeing during and following a public health emergency. Methods Eight scientific databases were searched from inception to 1 November 2022. Studies that described strategies to address the psychological impacts experienced by those responding to a public health emergency (i.e., a pandemic, epidemic, natural disaster, or mass casualty event) were eligible for inclusion. No limitations were placed based on study design, language, publication status, or publication date. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal tools. Discrepancies were resolved through discussion and a third reviewer when needed. Results were synthesized narratively due to the heterogeneity of populations and interventions. Outcomes were displayed graphically using harvest plots. Results A total of 20,018 records were screened, with 36 unique studies included in the review, 15 randomized controlled trials, and 21 quasi-experimental studies. Results indicate that psychotherapy, psychoeducation, and mind-body interventions may reduce symptoms of anxiety, burnout, depression, and Post Traumatic Stress Disorder, with the lowest risk of bias found among psychotherapy interventions. Psychoeducation appears most promising to increase resilience, with mind-body interventions having the most substantial evidence for increases in quality of life. Few organizational interventions were identified, with highly heterogeneous components. Conclusion Promoting healthcare workers' mental health is essential at an individual and health system level. This review identifies several promising practices that could be used to support healthcare workers at risk of adverse mental health outcomes as they respond to future public health emergencies.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=203810, identifier #CRD42020203810 (PROSPERO).
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Affiliation(s)
- Sarah E. Neil-Sztramko
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Emily Belita
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Stephanie Hopkins
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Diana Sherifali
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Laura Anderson
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Emma Apatu
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Lydia Kapiriri
- Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Jean Eric Tarride
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
- Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- Programs for Assessment of Technology in Health, Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Olivier Bellefleur
- National Collaborating Centre for Healthy Public Policy, Montreal, QC, Canada
| | | | | | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
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